UNIVERSITY OF WATERLOO Faculty of APPLIED HEALTH SCIENCES DESCRIPTION The cardiac rehabilitation practicum will focus on skill development in the areas of program administration, graded exercise testing, exercise prescription and exercise leading/supervision for people with coronary heart disease. Emphasis will be placed on "hands-on training" in an actual cardiac rehabilitation program, and the interpretation of case studies. Special topics discussed throughout the year will vary depending on needs and interests of the student and may include: (a) pathophysiology, (b) epidemiology-physical activity and CHD, (c) electrocardiography, (d) pharmacology, (e) compliance, and (f) risk factor modification. LOCATION: BMH 1402 + Hospital placement INSTRUCTORS: Caryl Russell, Room 1611, ext. 36379, crussell@uwaterloo.ca PREREQUISITES: KIN 407; previous practical experience with cardiac patients strongly preferred. COURSE RATIONALE: This course is designed to provide skills for students who may play a critical role in reducing the risk of subsequent attacks. COURSE OBJECTIVES: a) Provide quantifiable skill development in the areas of program supervision, graded exercise testing, exercise prescription and exercise leadership b) Provide an opportunity for group discussion and individual presentations on topics related to coronary heart disease. c) To assist students in developing proficiency in the interpretation of case studies COURSE CONTENT: 1) Two hours weekly lab 2) Two hour weekly clinical practice NOTE: Exercise Leading and Supervision will be an on-going component of the course and will involve hands-on-experience in the Hardy Hearts Cardiac Rehabilitation Program. REQUIRED TEXTS: 1. Guidelines for Exercise Testing and Exercise Prescription. Sixth Edition, American College of Sports Medicine, Lea & Febiger, Philadelphia, London, 2014
COURSE EVALUATION: Kin 492A (Fall Term) 1. Program Development and Management 30% Develop a model cardiac rehabilitation program appropriate for your home town. Due Date: Last Day of Class 2. Skills Acquisition: 30% 3. Class Presentation & Summary Sheet: 10% 4. Written Case Study at the End of term 30% 100% Kin 492 B (winter Term) 1. Exercise Leadership 20% Your leadership skills will be evaluated informally over the Fall and Winter terms. Feedback will be provided, as appropriate, at any time with established performance criteria as a basis for evaluation. 2. Graded Exercise Testing 40% The graded exercise test (GXT) performance evaluation will be a mock set-up. The GXT is to be conducted on a cycle ergometer. You will be responsible for checking that the appropriate equipment is at the testing site and arranged in such a manner to facilitate the testing process. No texts or course notes are allowed during the testing, however you can use blank data collection forms and informed consents. An informed subject will be provided by the examiner. For details regarding performance expectations refer to the hand-out provided at the beginning of the year. 3. Case Study/Exercise Prescription: 30% You will be provided with a case study and given Two hour to analyze it thoroughly and prepare a comprehensive exercise prescription, and respond to pertinent questions regarding the case. 4. Term Project: TBA 10% This project will be determined at the beginning of class and will relate to enhancing Hardy Hearts Program while developing your skills.
1. PROGRAM DEVELOPMENT GUIDELINES FOR CARDIAC REHABABILIATION PROPOSAL Introduction include a brief description of your community, including relevant characteristics Purpose outline goals and objectives of your rehabilitation program Program Description be very clear about when, where, who, how long provide a week schedule to demonstrate Exit Criteria: what determines how long the patient stays in the program? Patient Pool: who is eligibility, what is the specific criteria, where are referrals from, and where are referrals from Safety measures what factors and procedures will be put into place Organization and Administration describe the organizational model (use a block diagram depicting who is involved from administrators to volunteers) Personnel Describe the personal for the program, include job description, salary? Program Evaluation how will the program be evaluated for success (match to specific objectives) Financial considerations include a spread sheet with costs and expenses, estimate final profits. Include all estimated expenses (personal, facilities, equipment, office etc... Where can/does financial support come from? Suggested sources? Advertising and promotion: How would the program be promoted? Appendices - include medical history questionnaire, consent form, GXT data sheet, etc. References
Please consider the definition below when designing your program Developing Goals: The goals are broad statements of what the patient will be able to do when they have completed the program. Goals can be lofty ideas. Developing Measurable Objectives: Measurable objectives are the specific measures we use to determine whether or not we are successful in achieving the goal. The objectives are instructions about what we want the patient to be able to do. Use verbs and include specific conditions (how well or how many) that describe to what degree the patient will be able to demonstrate mastery of the task. "The goal is where we want to be. The objectives are the steps needed to get there." Example: Goals of Cardiac Rehabilitation Cardiac rehabilitation programs should be designed so that participants can work toward the following goals: Restoration of optimal physiological, psychological, and vocational status Prevention of progression or reversal of the underlying atherosclerosis process Reduction of risk of sudden death and re-infarction
2. Skill Acquisition KIN92 A All skills will be demonstrated individually to the instructor. You will be given a score of 0 - not satisfactory 1 - satisfactory 2 - well done Exercise Blood Pressure Heart rate determination & calculation ECG Identification Submaximal exercise test 3-2min stages, measuring HR, BP and RPE work rate calculation metronome calibration emergency response Demonstration of specific exercises (strength, endurance, warm-up, cool-down etc.) 3. CLASS PRESENTATION Select a topic to present to the class (10 minutes presentation) on a pre-approved topic. You will provide a one page summary of your talk to each person in the class, PLUS provide a condensed version for the Hardy Hearts News Letter. 4. CASE STUDY Hand in two case studies during the term and then during the last week of class you will be given a case study to evaluate according to the criterion outlined in class.